RN-ICU

1. Key Responsibilities
   1. Initiates and revises the plan of care/Kardex according to policy and individual patient needs.
   2. Participates in discharge planning per policy.
   3. Assesses patient per policy and need in age appropriate manner.
   4. Teaches patient and family about treatments, diagnosis, care, medications and discharge plan.
   5. Adapts nursing care to specific age group.  When unfamiliar, consults resource nurse or resource guide.
   6. Documents accurately and timely (at the time of occurrence) in the medical record the following\:  Assessments, Teaching, Family Involvement, Interventions, Patient response, Discharge plan, Implementation of MD orders, and medication.
   7. Assists director in other related duties as required and assigned.
• Responsibilities of RN Circulating Nurse\:

• Assess patients at intervals as stated I policies and procedures
• Develop and individualized perioperative plan of care using PNDS (Perioperative Nurse Data Set) guidelines.
• Assists director and charge nurse in other related duties as required and assigned
   
   
• Implement the plan of care using the following\:

1. Protect patient from injury caused by chemical, electrical, laser, positioning, thermal sources and extraneous object.
2. Perform count procedures to protect patient form unintended retained foreign objects
3. Perform interventions necessary to ensure patient’s procedure is performed on the correct site, side and level.
4. Manage patient’s specimen(s) in the appropriate manner
5. Communicate patient’s current status throughout the continuum of care
6. Administer medication(s) appropriately
7. Perform interventions to maintain patient’s wound and tissue perfusion at or above baseline levels
8. Perform intervention to maintain the status of the patient’s genitourinary, gastrointestinal, musculoskeletal, endocrine, respiratory, cardiovascular and neurological systems and fluid, electrolyte, and acid-base balances at or above baseline
9. Perform interventions to ensure the patient is at or returned to normothermia at the conclusion of the immediate postoperative period.
10. Perform interventions to protect patient from infection
11. Assess knowledge level of patient or designated support person and provide education regarding the expected psychosocial response, nutritional management, medication management, pain management, wound management, and expected responses to the operative or invasive procedure.
12. Actively involve patient or designated support person in decisions affecting his or her perioperative plan of care and the rehabilitation process
13. Protect patient’s rights, dignity and privacy
14. Provide culturally competent, age-appropriate, ethical care within legal standards of practice
15. Provide consistent and comparable care regardless of the setting.

• Evaluate the patient’s progress toward attaining outcomes
• Transfer care as appropriate
• Delegate tasks as appropriate according the state of ND Nurse Practice Act and job descriptions
• Document nursing care
• Collaborate effectively with other disciplines ad appropriate
• Participate in quality reviews and performance improvement projects
• Participate in the performance appraisal process
• Use problem-solving and conflict resolutions skills to foster effective work relationships with team members
• Maintain required competencies
• Attend required meetings and education al session. Complete LEARN assignments as assigned
• Act as a patient advocate and maintain privacy of all appropriate information
• Please refer to call schedule policy regarding call requirements.
• Responsibilities for Day Surgery RN\:

1. Responsibilities of Charge Nurse
• Admit surgical patients, discharge patients, start IV’s, give injections, port care, PIC line care, access ports and lab draws from ports. Makes patient placement decisions based on patient need and staff ability.
• Supervises CNAs, WCs, RNs and LPNs, acts as a resource to nursing staff on care problems, assists with patient care as requested by staff, confronts staff and takes appropriate action when necessary, assists in performance appraisals for a designated group of staff.
• Assesses staffing needs according to activity level, workload measurement, staffing pattern / skill mix, geographic districts and patient needs.
• Communicates effectively with all members of the health care team, patients and families, reporting critical incidents to Administrative staff, acting as a resource to physicians by providing information, contacting family when necessary, making rounds with physicians
• Assists with staff scheduling by approving trades, placing daily staff changes on permanent schedule and assisting with calling in staff/low census.
   
   
1. Charge Nurse responsibilities (specific to the Department of Surgery)
• Demonstrates knowledge of AORN standards and practice guidelines.
• Assures that physician preference cards are completed and updated.
• Assists in ordering supplies and equipment through controlled and approved purchasing mechanisms under the direction of the unit director.
• Assures availability of adequate supplies, equipment, instrumentation, and materials for the department and for scheduled cases.
• Assists with education and training of new and current employees as assigned.
• Demonstrates the ability to perform circulating and scrub nurse duties.
• Assists others in time of need (i.e. PTO, STD, etc.)
• Participates in quality control/process improvement programs.
• Coordinates repairs of equipment under the direction of the unit director.
• Performs clerical functions as needed for appropriate record keeping.
• Maintains all PAR levels in the area under the direction of the unit director.
• Assists in enforcing policies, procedures, and professionalism within the department and hospital; disciplinary action is the responsibility of the unit director but the RN-charge nurse assists the director with identifying issues for resolution.
• Assists with the overall flow of patient activities within the operating room, day surgery, and post anesthesia care unit under the direction of the unit director.
• Post assignments for the case board daily and make scheduling adjustments as needed
• Assist director in related duties as assigned
• Assists with the overall flow of patient activities within the Surgical Services department
• Assist staff with and monitor call schedule
• Use effective conflict resolution techniques
• Participate in interviews for staff selection
• Pursue professional growth and participate in a professional organization
• Demonstrate effective communication and collaboration skills with members of the perioperative team, other departments, patients and families.
• Act as clinical resource for perioperative services staff members using evidence-based knowledge and prevailing standards.
2. Responsibilities of a Perianesthesia Nurse\:

• Admission to PACU
• Assess type of anesthesia, monitor vital signs every 10-15 min & prn ( BP, pulse, O2 sat., resp., temp, EKG, consciousness, color, age specific assessment)
• Airway management
• Positioning/Safety measures as appropriate to procedure
• Intake & Outtake
• IV therapy, airway(Foley) catheter gastric, auto transfusion, drains)
• Dressings
• Pain & Comfort management
• Thermoregulation (Bear Paw, warm blanket)
• Labs-X-rays-respiratory
• Medication control-dispensing, documentation, ordering, charging
• Supply & equipment availability
•  Assisting Anesthesia staff –blocks/other injections
• On call work schedule
• Daily monitor documentations- Temps, crash cart, blanket warmer
• Family/significant other updates as indicated
• Transport patients to & from OR/PACU
• Update MDA/surgeon of complications
• Discharge from PACU to other unit (hands off communication)
   
   

1. Job Requirements/Qualifications
2. Current North Dakota Registered Nurse License
3. Capable of meeting the physical and emotional demand of the position
4. Unit Specific requirements\:

• Emergency Dept\:  CPI, BLS, ACLS, PALS and completion of Trauma Nursing Core Curriculum within one year of employment.  One year ICU/ Medical/Surgical experience preferred.
• Intensive Care Unit\:  CPI, BLS, ACLS and one year Medical/Surgical experience preferred; (required to advance to Charge Nurse role) and obtain ACLS and PALS within one year of employment in St. Joseph’s Intensive Care Unit
• Level II Nursery\:  NRP
• Perianesthesia Nurse\:  
  RN Lic/minimum 1 year Med/Surg/Peds experience
  BLS
  PALS
  ACLS
• Pediatrics\: BLS and  PALS
• RN Circulating Nurse\: 
  Preferred ACLS, CNOR
  Graduate from accredited school of nursing
  Current RN Lic in North Dakota

3.BLS certification\: required for all areas

1. ANCC Certification preferred

• Obstetrics
• Surgery
• Medical/Surgical
• Critical Care

1. BSN preferred
2. Must meet the criteria required for the nursing area
3. FIT testing
4. For Day Surgery RN\: Cross train to PACO (Recovery Room)